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An Assessment of Clinical Mentorship for Quality Improvement: The African Health Professions Regional Collaborative
Courtney S Drayton1, Sydney A Spangler, Thoko Lipato
1Courtney S. Drayton, MPH, RN, Global HIV Epidemiology Fellow Alumna, Public Health Institute/Centers for Disease Control and Prevention based in Atlanta, Georgia, USA. Sydney A. Spangler, PhD, MSN, CNM, is an Assistant Clinical Professor, Emory University, Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia, USA. Thokozire J. Lipato, MBA, BScN, RNM, is a Lecturer, Nursing and Midwifery, Mulanje College of Nursing and Midwifery, Lilongwe, Malawi. Marissa Robinson, DrPH, MPH, Rollins Earn and Learn Program (REAL) Public Health Practice Intern Alumna, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA. Muadi Mukenge, MA, is a Director Emeritus, African Health Professions Regional Collaborative (ARC), Emory University, Nell Hodgson Woodruff School Nursing, Atlanta, Georgia, USA. Agnes N. Waudo, is a Director, Africa Health Workforce Project and ARC Secretariat, Nairobi, Kenya. Jessica M. Gross, MSN, MPH, is a Epidemiologist, Division of Global HIV and TB, the U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Abstract:
The African Regional Collaborative for nurses and midwives funded quality improvement projects in five countries to enhance clinical mentorship programs supporting HIV service delivery for women, infants, and children. Each country team implemented specific interventions focused on the application of nurse-initiated and managed antiretroviral therapy guidelines and competencies. A site-level tool, the nursing practice framework, measured structural maturation in clinical mentorship programs across five stages at eight facilities. Clinical competencies that aligned with the framework were evaluated through a provider-level knowledge assessment to identify on-going needs for mentees before and after the implementation period. Key trends observed in the assessment include positive program progression for all facilities; competencies were higher for pregnant and breastfeeding women and lower for HIV-exposed infants; there was an increase in posttest participation for all facilities. The nursing practice framework provides a rapid assessment of structural changes and exploration of context to identify quality improvement needs.
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